| NPI | 1255406351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN L OTTO President 206-542-7406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD00001604) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD00001235) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2012-09-18 |